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Primary Care Provider NP

Primary Care Provider NP

Job ID 
# of Openings 
Job Locations 
US-IA-Windsor Heights
Posted Date 
PACE Pathways

More information about this job


Provides primary medical management in collaboration with the Immanuel Pathways physician(s). Following initial and semi-annual assessments completed by the provider, performs additional physical assessments of participants as needed, and then develops and  implements appropriate plans of care to Immanuel Pathways program participants. Practices collaboratively with the Medical Director and Primary Care Physician(s) following protocols developed within the specified Code of State Regulations. Evaluates participant’s expressed concerns and recommends appropriate treatment to the Interdisciplinary Team (IDT) for decision.  Provides participants and their caregivers with instruction and education. At the direction of the Medical Director, functions as a member of the IDT and informs the IDT of the medical condition of each participant, remaining alert to pertinent input from other team members, participant’s caregivers, as well as documenting changes in a participant’s medical record consistent with documentation policies. Works with the Medical Director to coordinate scheduling and care for participants in the clinic. Performs rounds in the Immanuel Pathways contracted provider locations ie; nursing home, hospital and assisted living. Must notify Immanuel Pathways and State Board of Nursing of change in residence. Supports and lives out Immanuel’s Mission and CHRIST Promises. Supports and lives out Immanuel’s Mission and CHRIST Promises.


Key Areas

Key Responsibilities and Duties of the Job

75% Participant Care

  • Provides primary medical coverage in collaboration with Immanuel Pathways physicians. Completes initial, semi-annual and unscheduled assessments.
  • Develops and implements appropriate plans of care, as determined by the IDT, to Immanuel Pathways program participants. 
  • Integrates the approved primary care treatment plan into the overall plan of care developed by the IDT. Interacts with team members to meet emergent and acute need of participants.  Participates in discharge planning for acute and long-term placement.
  • Functions as a member of the IDT. Attends and participates in IDT meetings; communicates participant changes, collaborates on care planning decisions and coordination for 24 hour care delivery.
  • Evaluates and treats participants during acute illness. Manages participants’ chronic illnesses and conditions in collaboration with the physician(s).
  • As requested and directed by the Primary Care Physician, manages care of participants when residing in contracted provider environments; ie; hospital, nursing home or assisted living. Provides regular visits as determined by IDT and in collaboration with provider and participant need. Performs telephone contact with contracted provider staff as needed. 
  • Provides preventive health maintenance for participants, including immunizations, screenings and monitoring of pertinent indicators. Follows the Immanuel Pathways clinical protocol.
  • Prudently prescribes medications, therapies and other treatments for participants.
  • Following consultation with the Primary Care Physician refers participants to medical specialist as indicated. 
  • Complies with state Home Health Licensure regulations for home care.

20% Quality Standards

  • Works with Medical Director and Clinic Manager to formulate clinical policies, procedures and standards of care.
  • Advises the Medical Director and Primary Care Physician(s) in ways and means to establish better accountability of Immanuel Pathways  services to participants and referral sources, keeps Medical Director aware of needed material and human resources as program expands. 
  • Acts as resource during intake of new participants and in the day-to-day operation of the center programs.
  • Provides training and clinical support to Immanuel Pathways staff.
  • Takes it upon self to educate others related to policies and procedures when non-compliance is observed.
  • Champions necessary and continuous changes in order to improve.
  • Participates in peer review with Medical Group. 
  • Serves as a resource for patient safety.
  • Participates in and supports Quality Improvement Initiatives

5% Professional Activities

  • Assumes responsibility for professional activities and growth. Keeps abreast of current nursing knowledge, especially in the field of geriatrics by attending professional seminars and conferences.
  • Participates in team meeting, staff meetings and monthly in service meetings.

5% Other

Perform other duties as required or requested. 




  • Current Certification as a Nurse Practitioner, in good standing, with prescriptive authority in the respective state in which he/she is employed, is required.
  • RN license in the respective state in which he/she is employed is required.


  • Two (2) years treating patients in a hospital, skilled care, or other health related entity is required.
  • One (1) year of management experience, preferably in a geriatric care setting required.
  • One (1) year of experience working with the frail or elderly is required.

Other Requirements-

  • Must have medical clearance for communicable diseases and up-to-date immunizations before having direct participant contact.
  • Must have a valid driver’s license, proof of insurance and have means of transportation.
  • Basic Life Support (BLS) Skills i.e. Health Care Level Cardiopulmonary resuscitation (CPR); Automated External Defibrillator (AED); First Aide (FA).

KSA- Knowledge Skills and Abilities-

  • Knowledge of current concepts, theories and practices related to home and community-based care for the elderly and disabled adults.
  • Knowledge of health care delivery and financing systems, including Medicaid, Medicare, waiver programs, prospective and systems with a monetary cap, public health programs and Health Maintenance Organization (HMO)/Managed Care.
  • Knowledge of the PACE regulations
  • Knowledge of physical, mental and social needs of frail older adults.
  • Skilled in oral and written communication
  • Skilled in organizing time, priorities, and duties
  • Ability to lead and work within the interdisciplinary setting.
  • Ability to supervise medical staff effectively.
  • Ability to chart via Electronic Health Records
  • Proven experience and basic computer proficiency (internet, email, Microsoft Office)
  • Ability to manage changing priorities per needs of the PACE program and the agency.
  • Ability to effectively and efficiently plan, prioritize and follow-up on delegated responsibilities.
  • Ability to foster collaborative working relationships.

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